No abstract available.
Diagnosis* ; Molar* ; Radiography, Panoramic*

PURPOSE: To determine the head position that the superior border of the mandibular canal as well as mental foramen can be more clearly visualized in panoramic radiography MATERIALS AND METHODS: Ten dry mandibles were radiographed bilaterally using PM 2002 CC panoramic machine. A 20 mm thick aluminium filter was added to the slit collimator to obtain radiographs with acceptable density. The specimens were tilted by 2, 4, 6, 8, and 10 degrees downward with and without radiopaque markers. Radiopaque markers were inserted into the mandibular canals and the mental canals of each side of the specimens to serve as reference image when assessing the radiographs. The visibility of the mandibular canal and the mental foramen was estimated by 4 observers on all radiographs. The obtained results were analyzed statistically. RESULTS: Mandibular canals were significantly more clearly visible in the radiographs with 4 and 6 degree downward position on both sides (P<0.05). Mental foramens were significantly more clearly visible in the radiographs with 4, 6, and 8 degree downward on right side and 6 degree downward on left side (P<0.05). There was not significant difference between right and left sides. CONCLUSION: Panoramic radiographs with 4 to 6 degree downward tilting could be valuable in locating the mandibular canal as well as the mental foramen.
Head ; Mandible ; Radiography ; Radiography, Panoramic*

PURPOSE: To evaluate the magnification error percentage in repeatedly taken panoramic radiographs of same patient and machine. MATERIALS AND METHODS: 92 panoramic radiographs from 46 patients were traced and 30 horizontal and vertical measurements were made with digital sliding caliper. The results were compared with paired t-test. RESULTS: There was no statistically significant difference between the two measurements. The overall difference as percentage error was 6.19+/-5.60%. The largest error as 14.61+/-12.44% was found at condylar height 1, and smallest as 1.86+/-1.61% at mandibular height. Overall vertical error excluding condylar height 1 was 3.76+/-3.97%, and the horizontal error 6.88+/-5.92%. CONCLUSION: Repeatedly taken panoramic radiographs of the same patient and machine was reliable since there was no significant percentage error difference but the percentage error ranged from 1.86+/-1.61% to 14.61+/-12.44% indicating the error depends on the measuring site.
Diagnostic Imaging ; Humans ; Radiography, Panoramic*

PURPOSE: Panoramic radiographs taken using conventional chin-support devices have often presented problems with positioning accuracy and reproducibility. The aim of this report was to propose a new bite block for panoramic radiographs of anterior edentulous patients that better addresses these two issues. MATERIALS AND METHODS: A new panoramic radiography bite block similar to the bite block for dentulous patients was developed to enable proper positioning stability for edentulous patients. The new bite block was designed and implemented in light of previous studies. The height of the new bite block was 18 mm and to compensate for the horizontal edentulous space, its horizontal width was 7 mm. The panoramic radiographs using the new bite block were compared with those using the conventional chin-support device. RESULTS: Panoramic radiographs taken with the new bite block showed better stability and bilateral symmetry than those taken with the conventional chin-support device. Patients also showed less movement and more stable positioning during panoramic radiography with the new bite block. CONCLUSION: Conventional errors in panoramic radiographs of edentulous patients could be caused by unreliability of the chin-support device. The newly proposed bite block for panoramic radiographs of edentulous patients showed better reliability. Further study is required to evaluate the image quality and reproducibility of images with the new bite block.
Humans ; Radiography, Panoramic ; Reproducibility of Results

ABSTRACT Panoramic X-ray is well known to cause DNA damage and induces cellular death. The aim of the present study was to evaluate the cytotoxicity of radiation exposure from panoramic radiography on human buccal mucosa cells by assessing the cell viability using the simple-trypan blue exclusion test. The genotoxicity effect was evaluated by assessing comet assay score. This research included a total of 20 healthy patients who had panoramic radiography for a routine dental examination. Buccal mucosa cells were collected from all participants before X-ray exposure and at 30 min or 24 h after exposure in Groups 1 and 2, respectively, and subjected to a comet assay and trypan blue exclusion test to assess cell viability and DNA damage. Cell viability was calculated as the ratio of live (translucent) to total counted cells. Comet assay output images were analysed using OpenComet software and a visual score by measuring the percentages of tail DNA and summing the visual score, respectively. A statistically significant (p < 0.05) reduce in cell viability was observed at 30 min after exposure, furthermore there is no more reduction after 24 h. Both comet assay measurements showed a significant (p < 0.05) increase in the percentage of tail DNA and visual score at 30 min after exposure, then tend to decrease after 24 h of exposure, although it was not significant (p > 0.05). The results showed that panoramic radiography interfered cell viability and induced DNA damage in buccal mucosa cells within 30 min after exposure, but these effects were ceased after 24 h.
Mouth Mucosa--cytology ; Radiography, Panoramic

PURPOSE: To determine whether the mandibular radiomorphometric indices in panoramic radiography are correlated with the bone mineral density of Cu-equivalent images in intraoral film. MATERIALS AND METHODS: The bone mineral density (BMD) of the mandibular premolar area was measured in the Cu-equivalent image of intraoral film. The Panoramic Mandibular Index (PMI) and Mandibular Cortical Width (MCW) were measured in panoramic radiographs of six dry mandibles, and the Pearson correlation between PMI, MCW, and BMD were tested. RESULTS: There were no significant correlations between PMI and BMD (r = 0.280), nor between MCW and BMD (r = 0.237). CONCLUSION: The results show that PMI and MCW were poor diagnostic indicators of mandibular BMD in the six dry mandibles used in this study. The correlationship between the mandibular radiomorphometric indices (PMI and MCW) and mandibular BMD needs to be researched further using large in vivo patient samples.
Bicuspid ; Bone Density* ; Humans ; Mandible ; Radiography, Panoramic

PURPOSE: The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. MATERIALS AND METHODS: The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral & maxillofacial radiologists (observer A&B), two oral & maxillofacial surgeons (observer C&D), and two general dentists (observer E&F). RESULTS: Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A&B, 93.5% in observer C&D and 80.4% in observer E&F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. CONCLUSION: Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.
Dentists ; Humans ; Mandible ; Mandibular Fractures ; Radiography, Panoramic

PURPOSE: This study was performed to evaluate the reproducibility of panoramic radiographs of dentulous and edentulous patients. MATERIALS AND METHODS: The reproducibility of panoramic radiographs was evaluated using the panoramic radiographs acquired from 30 anterior dentulous patients by using a common biting positioning device (dentulous group) and 30 anterior edentulous patients by using chin-support devices to take a panoramic radiograph (edentulous group), respectively; these patients had undergone 3 or more panoramic radiographs. The widths and angles between the designated landmarks were measured on the panoramic radiographs, and the reproducibility was evaluated using the intraclass correlation coefficient (ICC) and the coefficient of variation. RESULTS: In the dentulous and edentulous groups, the ICCs of the mandibular ramus and mandibular angle areas were higher than the condylar head and zygomatic areas. The mandibular ramus and angle areas showed statistically lower mean coefficients of variation than the condylar head and zygomatic areas in the dentulous group. The mandibular angle area showed a significantly lower mean coefficient of variation than the zygomatic area in the edentulous group. By comparing the two groups, each ICC of the edentulous group was lower than that of the dentulous group, and the mean coefficients of variation of the mandibular ramus area, zygomatic area, left condylar inclination, and ramus ratio between the right and the left in the edentulous group were significantly higher than those in the dentulous group. CONCLUSION: Biting positioning for dentulous patients provided better positioning reproducibility than chin-support positioning when performing panoramic radiography for edentulous patients.
Head ; Humans ; Radiography, Panoramic ; Reproducibility of Results

PURPOSE: The objective of this study was to compare clinical examination of of dental caries and secondary caries with panoramic examination, and to examine bone lesions and dental anomaly of unerupted state. MATERIALS AND METHODS: In this study, clinical records and panoramic radiographs were available for 89 first grade students in elementary school. Dental caries of occlusal surfaces, proximal surfaces, and buccolingual surfaces were examined . Secondary caries was examined too. In addition, the central lesion and dental anomaly of unerupted state were examined in panoramic radiographs. RESULTS: The obtained results were as followed : 1. Carious detectability of clinical examination in occlusal and buccolingual surface was higher than that of panoramic examination, but it is statistically insignificant(p>0.05). In proximal surface, carious detectability of panoramic examination was higher than that of clinical examination, and it is statistically significant(p<0.01). 2. In contrast to clinical examination only, when the two examination methods were combined, there was additional detection of dental caries(26.7% in occlusal surface, 48.2% in proximal surface, 33.3% in buccolingual surface, and 38.3% totally). 3. In detection of secondary caries, panoramic examination had lower ability than clinical examination in all three surfaces, but in case that both methods were combined, totally 36.0% extra carious lesions were detected. 4. In panoramic examination, detectability of secodary caries in upper teeth is lower than lower teeth. 5. In panoramic examination, it was possible to detect the central lesions and dental anomalies of unerupted state which cannot be detected in clinical examination. CONCLUSION: It is useful to combine the panoramic examination with clinical examination in order to increase carious detectability and to evaluate the central lesions and dental anomalies of unerupted state
Dental Caries* ; Diagnosis* ; Humans ; Radiography, Panoramic* ; Tooth

Dental development is valuable for age estimation of children because of its low variability and less affection by endocrine and nutritional status. Demirjian reported a new system of dental age assessment in 1973 and this method has been used in many countries. The accuracy of Demirjian's method in dental age estimation may be affected by ethnic difference. For Korean population, the population study of Demirjian technique has not accomplished yet, therefore, we investigate and analyze the validity of Demirjian's method in Korean population. The 155 orthopantomographys which consisted of 87 boys and 68 girls were randomly selected and the age range was 5 to 16 years. The age of radiography was estimated according to criteria presented by Demirjian. Statistical analysis was preformed between real age and estimated age. In boys, there was no significant difference observed (p=0.171) between the real age and estimated age, however in girls, significant difference was shown (p=0.022) in 95% confidence interval. In both groups, there was clear overestimation tendency below 8.0 year, but over 8.0 year the difference pattern is atypical. The Pearson correlation coefficients between real age and estimated age were 0.970, 0.964 in boys, girls, respectively and showed positive relationship. The standards of dental maturation reported by Demirjian may not be applicable in Korean children especially in girls. Establishment of new maturation scores and percentiles curves for Korean population with many samples is required for more accurate age estimation.
Child ; Humans ; Nutritional Status ; Radiography, Panoramic